CHILD WAIVER FORM
My child(ren) has permission to travel to, attend, and participate in ReLeaf Cville (RC) and Partner sponsored activities. I understand that my child(ren) will follow rules and safety protocols outlined by RC.
I understand RC activities may involve: “hands on” activities such as boating, hiking on rough, uneven terrain (including up and down steep hills, muddy stream banks, and loose riprap), planting trees and plants, and other outdoor activities. I know and understand the risks and dangers involved in the above-named activities, including possible transmission of disease between individuals and from natural sources. I also know and understand that unanticipated dangers might arise.
I hereby release RC from any responsibility for any injury, illness, or property damage which might occur as a result of participation in RC activities. I give permission for medical personnel to carry out such emergency diagnostic and therapeutic procedures as may be necessary for my child, and also permit such treatment procedures to be carried out at and by local hospital(s) for my child in the event of an emergency. I understand that any medical expenses will be billed directly to me or my insurance company.
I acknowledge that RC is doing everything it can to protect my child and the public.
MEDIA CONSENT: I hereby grant the RC the unconditional right to use my child’s name, voice, and photographic likeness in connection with any audio video production, articles, website materials or press releases, but not as an endorsement. Under no circumstances will a name be used in conjunction with an image or voice without prior consent.